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Volume 11(3); June 2020
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Editorial
The Impact of Social Distancing on the Transmission of Influenza Virus, South Korea, 2020
Young June Choe, Jong-Koo Lee
Osong Public Health Res Perspect. 2020;11(3):91-92.   Published online June 1, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.3.07
  • 5,070 View
  • 239 Download
  • 14 Citations
PDF
Review Article
COVID-19 Outbreak in Malaysia
Asita Elengoe
Osong Public Health Res Perspect. 2020;11(3):93-100.   Published online June 1, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.3.08
  • 65,535 View
  • 3,665 Download
  • 58 Citations
AbstractAbstract PDF

In 2020 a significant threat to public health emerged. The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic outbreak emerged in December 2019 from Wuhan City, Hubei Province, China and spread to the rest of the world. This disease was named COVID-19 by World Health Organization. To date (17th April 2020) a total of 2,230,439 cases of COVID-19; 150,810 cases of deaths and 564,210 recovered cases have been reported worldwide. In this review the SARS-CoV-2 morphology, pathogenic mechanism, similarities and differences between SARS-CoV and Middle East Respiratory Syndrome and severe acute respiratory syndrome, transmission mode, diagnosis, treatment, and preventive measures were investigated. The outbreak of COVID-19 from a Malaysian perspective was explored and mental health care during the COVID-19 outbreak was explored. To date, there is no vaccine or no specific treatment for COVID-19. Therefore, preventive measures are very important to prevent and control the rapid spread of the SARS-CoV-2 virus. Preparedness should be a priority for future pandemic outbreaks.

Original Articles
Genome-Wide Identification and Characterization of Point Mutations in the SARS-CoV-2 Genome
Jun-Sub Kim, Jun-Hyeong Jang, Jeong-Min Kim, Yoon-Seok Chung, Cheon-Kwon Yoo, Myung-Guk Han
Osong Public Health Res Perspect. 2020;11(3):101-111.   Published online May 14, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.3.05
  • 11,066 View
  • 487 Download
  • 49 Citations
AbstractAbstract PDF
Objectives

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, in December 2019 and has been rapidly spreading worldwide. Although the causal relationship among mutations and the features of SARS-CoV-2 such as rapid transmission, pathogenicity, and tropism, remains unclear, our results of genomic mutations in SARS-CoV-2 may help to interpret the interaction between genomic characterization in SARS-CoV-2 and infectivity with the host.

Methods

A total of 4,254 genomic sequences of SARS-CoV-2 were collected from the Global Initiative on Sharing all Influenza Data (GISAID). Multiple sequence alignment for phylogenetic analysis and comparative genomic approach for mutation analysis were conducted using Molecular Evolutionary Genetics Analysis (MEGA), and an in-house program based on Perl language, respectively.

Results

Phylogenetic analysis of SARS-CoV-2 strains indicated that there were 3 major clades including S, V, and G, and 2 subclades (G.1 and G.2). There were 767 types of synonymous and 1,352 types of non-synonymous mutation. ORF1a, ORF1b, S, and N genes were detected at high frequency, whereas ORF7b and E genes exhibited low frequency. In the receptor-binding domain (RBD) of the S gene, 11 non-synonymous mutations were observed in the region adjacent to the angiotensin converting enzyme 2 (ACE2) binding site.

Conclusion

It has been reported that the rapid infectivity and transmission of SARS-CoV-2 associated with host receptor affinity are derived from several mutations in its genes. Without these genetic mutations to enhance evolutionary adaptation, species recognition, host receptor affinity, and pathogenicity, it would not survive. It is expected that our results could provide an important clue in understanding the genomic characteristics of SARS-CoV-2.

Detection and Isolation of SARS-CoV-2 in Serum, Urine, and Stool Specimens of COVID-19 Patients from the Republic of Korea
Jeong-Min Kim, Heui Man Kim, Eun Jung Lee, Hye Jun Jo, Youngsil Yoon, Nam-Joo Lee, Junseock Son, Ye-Ji Lee, Mi Seon Kim, Yong-Pyo Lee, Su-Jin Chae, Kye Ryeong Park, Seung-Rye Cho, Sehee Park, Su Jin Kim, Eunbyeol Wang, SangHee Woo, Aram Lim, Su-Jin Park, JunHyeong Jang, Yoon-Seok Chung, Bum Sik Chin, Jin-Soo Lee, Duko Lim, Myung-Guk Han, Cheon Kwon Yoo
Osong Public Health Res Perspect. 2020;11(3):112-117.   Published online May 8, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.3.02
  • 10,031 View
  • 507 Download
  • 77 Citations
AbstractAbstract PDF
Objectives

Coronavirus Disease-19 (COVID-19) is a respiratory infection characterized by the main symptoms of pneumonia and fever. It is caused by the novel coronavirus severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), which is known to spread via respiratory droplets. We aimed to determine the rate and likelihood of SARS-CoV-2 transmission from COVID-19 patients through non-respiratory routes.

Methods

Serum, urine, and stool samples were collected from 74 hospitalized patients diagnosed with COVID-19 based on the detection of SARS-CoV-2 in respiratory samples. The SARS-CoV-2 RNA genome was extracted from each specimen and real-time reverse transcription polymerase chain reaction performed. CaCo-2 cells were inoculated with the specimens containing the SARS-COV-2 genome, and subcultured for virus isolation. After culturing, viral replication in the cell supernatant was assessed.

Results

Of the samples collected from 74 COVID-19 patients, SARS-CoV-2 was detected in 15 serum, urine, or stool samples. The virus detection rate in the serum, urine, and stool samples were 2.8% (9/323), 0.8% (2/247), and 10.1% (13/129), and the mean viral load was 1,210 ± 1,861, 79 ± 30, and 3,176 ± 7,208 copy/µL, respectively. However, the SARS-CoV-2 was not isolated by the culture method from the samples that tested positive for the SARS-CoV-2 gene.

Conclusion

While the virus remained detectable in the respiratory samples of COVID-19 patients for several days after hospitalization, its detection in the serum, urine, and stool samples was intermittent. Since the virus could not be isolated from the SARS-COV-2-positive samples, the risk of viral transmission via stool and urine is expected to be low.

Development and Utilization of a Rapid and Accurate Epidemic Investigation Support System for COVID-19
Young Joon Park, Sang Yun Cho, Jin Lee, Ikjin Lee, Won-Ho Park, Seungmyeong Jeong, Seongyun Kim, Seokjun Lee, Jaeho Kim, Ok Park
Osong Public Health Res Perspect. 2020;11(3):118-127.   Published online May 20, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.3.06
  • 8,589 View
  • 271 Download
  • 14 Citations
AbstractAbstract PDF
Objectives

In this pandemic situation caused by a novel coronavirus disease in 2019 (COVID-19), an electronic support system that can rapidly and accurately perform epidemic investigations, is needed. It would systematically secure and analyze patients’ data (who have been confirmed to have the infection), location information, and credit card usage.

Methods

The “Infectious Disease Prevention and Control Act” in South Korea, established a legal basis for the securement, handling procedure, and disclosure of information required for epidemic investigations. The Epidemic Investigation Support System (EISS) was developed as an application platform on the Smart City data platform.

Results

The EISS performed the function of inter-institutional communication which reduced the processing period of patients’ data in comparison to other methods. This system automatically marked confirmed cases’ tracking data on a map and hot-spot analysis which lead to the prediction of areas where people may be vulnerable to infection.

Conclusion

The EISS was designed and implemented for use during an epidemic investigation to prevent the spread of an infectious disease, by specifically tracking confirmed cases of infection.

Short Communications
Detection of Novel Coronavirus on the Surface of Environmental Materials Contaminated by COVID-19 Patients in the Republic of Korea
Sang-Eun Lee, Deog-Yong Lee, Wook-Gyo Lee, ByeongHak Kang, Yoon Suk Jang, Boyeong Ryu, SeungJae Lee, Hyunjung Bahk, Eungyu Lee
Osong Public Health Res Perspect. 2020;11(3):128-132.   Published online May 8, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.3.03
  • 5,925 View
  • 261 Download
  • 18 Citations
AbstractAbstract PDF

This study aimed to determine the presence of SARS-CoV-2 on surfaces frequently touched by COVID-19 patients, and assess the scope of contamination and transmissibility in facilities where the outbreaks occurred. In the course of this epidemiological investigation, a total of 80 environmental specimens were collected from 6 hospitals (68 specimens) and 2 “mass facilities” (6 specimens from a rehabilitation center and 6 specimens from an apartment building complex). Specific reverse transcriptase-polymerase chain reaction targeting of RNA-dependent RNA polymerase, and envelope genes, were used to identify the presence of this novel coronavirus. The 68 specimens from 6 hospitals (A, B, C, D, E, and G), where prior disinfection/cleaning had been performed before environmental sampling, tested negative for SARS-CoV-2. However, 2 out of 12 specimens (16.7%) from 2 “mass facilities” (F and H), where prior disinfection/cleaning had not taken place, were positive for SARS-CoV-2 RNA polymerase, and envelope genes. These results suggest that prompt disinfection and cleaning of potentially contaminated surfaces is an effective infection control measure. By inactivating SARS-CoV-2 with disinfection/cleaning the infectivity and transmission of the virus is blocked. This investigation of environmental sampling may help in the understanding of risk assessment of the COVID-19 outbreak in “mass facilities” and provide guidance in using effective disinfectants on contaminated surfaces.

Coronavirus Disease-19: Quarantine Framework for Travelers Entering Korea
Osong Public Health Res Perspect. 2020;11(3):133-139.   Published online May 8, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.3.04
  • 4,809 View
  • 149 Download
  • 6 Citations
AbstractAbstract PDF

South Korea is operating a flexible quarantine management system which is based on the results of epidemiological investigations of patients arriving from overseas with coronavirus disease-19 (COVID-19), and closely monitoring COVID-19 outbreaks. South Korea has designated countries with a localized, high prevalence of infection as “quarantine inspection required areas” and has reinforced quarantine measures by applying special immigration procedures for people entering South Korea. Furthermore, South Korea also provides information on international travel history of entrants (who are South Korean citizens and foreign nationals) to all medical institutions, through the smart quarantine information system. On March 11th 2020, the World Health Organization characterized COVID-19 as a pandemic. Inevitably, the number of patients from overseas with COVID-19 (based on 10,000 people entering South Korea), increased to 10 cases in the second week of March, 37 cases in the third week, and 67.7 cases in the fourth week. However, after enforcing quarantine strengthening measures, and with a decrease in the number of people entering the country, the number of cases decreased to 52.0 in the first week of April.

Early Trend of Imported COVID-19 Cases in South Korea
Osong Public Health Res Perspect. 2020;11(3):140-145.   Published online May 4, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.3.01
  • 3,972 View
  • 126 Download
  • 2 Citations
AbstractAbstract PDF

This study aimed to observe the initial trend of imported COVID-19 cases in South Korea since the beginning of the outbreak. All imported cases were classified into 5 regions (China, Asia, Europe, Africa, and America) according to travel history and potential exposure to the COVID-19. The list of countries for which confirmed cases had a travel history (single visit, multiple visits) and presented, were used to estimate the potential “exposure countries” of confirmed cases. For better understanding of the overall imported cases, time differences (day) among 3 major steps (symptom onset, entry to South Korea, laboratory confirmation) were measured based on available data. From the first importation of a COVID-19 case on January 20th, a total of 171 imported cases have been officially reported in South Korea as of March 23rd 2020. The overall trend of importation has significantly changed during this period. Importation of confirmed cases were initially from China, and subsequently from other Asian countries. After that, importation from Europe rapidly increased, with importation from America also increasing. One hundred fifteen (81%) were confirmed within 7 days of symptom onset. One Hundred forty three (84.1%) imported cases were confirmed within a week after entry into South Korea. One hundred seven imported cases (75.9%) developed symptoms within 5 days before or after, entry to South Korea. Streamlined processes of detection, subsequent testing, isolation, and treatment by public health authority, was key in minimizing the risk of secondary transmission.

Corrigendum

PHRP : Osong Public Health and Research Perspectives